Ekvivalent: Mikrobiološki uzročnici kroničnog rinosinuitisa i njihova antimikrobna osjetljivost - utjecaj na antibiotsku profilaksu i liječenje

professional thesis

• Title (english): Equivalent: Microbial causative agents and their antimicrobial susceptibility patterns in chronic rhinosinusitis – impact on antibiotic prophylaxis and treatment
• Author: Denis Ferenec
• Mentor: Marko Velimir Grgić (mentor)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-12-19, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Kronični rinosinuitis (KRS) je iscrpljujuće stanje koje čini upala nosne sluznice i sluznice paranazalnih sinusa, a zahtjeva konzervativnu i, ponekad, kiruršku terapiju. Funkcionalna endoskopska operacija sinusa je kirurška procedura koja se primjenjuje za KRS. Tijekom takve procedure može se vršiti i druga dodatna dijagnostika. Prije samog zahvata provodi se preoperativna antibiotska profilaksa. U tom slučaju, empirijski aplicirana antibiotska terapija treba pokrivati najčešće mikrobne uzročnike za navedeno stanje.
Cilj ove studije bio je identificirati mikrobne uzročnike izolirane iz sino-nazalnih šupljina kod pacijenata koji su bili podvrgnuti endoskopskoj operaciji sinusa te im odrediti bakterijsku osjetljivost kako bi se dobiveni podaci mogli potom usporediti s trenutno važećim smjernicama za antibiotsko liječenje i perioperativnu antibiotsku profilaksu. Provedeno je retrospektivno kohortno istraživanje na 456 uzoraka prikupljenih od 2016. do 2019. godine u sklopu Klinike za otorinolaringologiju i kirurgije glave i vrata i Zavoda za mikrobiologiju, parazitologiju i hospitalne infekcije na Kliničkoj bolnici Sestara milosrdnica u Zagrebu.
Najčešće izolirani patogeni bili su Peptostreptococcus spp., Propionibacterium spp., Staphylococcus aureus, Pseudomonas spp., Fusobacterium spp. i Haemophilus influenzae. Prema dobivenim antibiogramima može se zaključiti da je empirijska terapija amoksicilin-klavulanskom kiselinom za ove uzročnike zadovoljavajuća. Međutim, primjena metronidazola empirijski ili za preoperativnu kiruršku profilaksu se ne preporučuje zbog visokog udjela rezistencije na navedeni antibiotik unutar skupine anaerobnih bakterija.

Abstract (english)

Chronic rhinosinusitis (CRS) is debilitating condition comprising inflammation of the mucosa of the nasal and paranasal sinuses, requiring conservative and often surgical treatment. Functional endoscopic sinus surgery (FESS) is a CRS treatment during which a microbiological diagnostic procedure may be conducted. Preoperative antibiotic prophylaxis is administrated before FESS. When indicated, the administered empiric antibiotic therapy must cover most common causing microbial agents. The aims of this study were to identify microbial pathogens isolated from sinonasal cavities in patients undergoing endoscopic sinus surgery, to determine bacterial antibiotic susceptibility patterns and compare them with guidelines for treatment and perioperative prophylactic use of antimicrobial agents. A retrospective cohort study on 456 samples collected between 2016 and 2019 was conducted at the Department of Otorhinolaryngology, Head and Neck Surgery and the Department of Microbiology, Parasitology and Hospital Infections in the Clinical University Centre Sestre milordnice, Zagreb. The most common isolated pathogens were Peptostreptococcus spp., Propionibacterium spp., Staphylococcus aureus, Pseudomonas spp., Fusobacterium spp. and Haemophilus influenzae. According to antibiotic susceptibility patterns, empiric antibiotic treatment with amoxicillin-clavulanic acid was appropriate. Due to high rates of antibiotic resistance of anaerobic bacterial isolates to metronidazole, it cannot be recommended in empirical antibiotic treatment or preoperative surgical antibiotic prophylaxis.

• Keywords: Kronični rinosinuitis; sinusna endoskopska kirurgija; antibiotska rezistencija; antibiotska profilaksa
• Keywords (english): Chronic rhinosinutis; sinus endoscopic surgery; antibiotic resistance; antibiotic prophylaxis
• Language: english
• URN:NBN: urn:nbn:hr:105:641437
• Study programme: Title: Otorhinolaryngology; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra otorinolaringologije (sveučilišni/a magistar/magistra otorinolaringologije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2025-02-18 09:31:47